33D2237041 CLIA NUMBER - WALGREENS NO 13961

Laboratory Demographics

  • CLIA Code: 33D2237041
  • Facility Name: WALGREENS NO 13961
  • Facility Address: 12 E JERICHO TPKE
    MINEOLA, NY
    ZIP 11501
  • Facility Phone: 516 739-2408
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD FAKHOVRI
  • NPI Number: 1881609956
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2237041
LAB Type Pharmacy
Facility Name WALGREENS NO 13961
Street 12 E JERICHO TPKE
City MINEOLA
State NY
ZIP 11501
Phone 516 739-2408
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2021
Certificate Expiration Date 3/26/2027
Facility Type Pharmacy
Lab Director DR. ZEIAD FAKHOVRI

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This page was last updated on: 9/29/2025